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Prevalence and quality of clinical pathways in Swedish intensive care units: a national survey

Authors

  • Petronella Bjurling-Sjöberg CCRN MSc,

    Doctoral Student, Corresponding author
    1. Department of Public Health and Caring Sciences, Section of Caring Sciences and Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
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  • Inger Jansson RN PhD,

    Senior Lecturer
    1. Department of Social and Health Sciences, Halmstad University, Uppsala, Sweden
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  • Barbro Wadensten RN PhD,

    Associate Professor, Senior Lecturer
    1. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden
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  • Gabriella Engström RNT PhD,

    Associate Professor
    1. Christine E. Lynn College of Nursing, Atlantic University, Florida, Boca Raton, USA
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  • Ulrika Pöder CCRN PhD

    Senior Lecturer
    1. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden
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Abstract

Rationale, aims and objectives

To identify the prevalence of clinical pathways (CPs) in Swedish intensive care units (ICUs) and to explore the quality, content and evidence base of the documents.

Methods

A descriptive and explorative survey of all Swedish ICUs (N84) and a review of submitted examples of CPs (n12) were conducted.

Results

CPs were in use at 20% of the Swedish ICUs. There was a significant geographic variation but no relationship between the use of CPs and category of hospital, type of ICU, size of ICU or type of health record applied. In total, 56 CPs were reported within a range of scopes and extensions. The content of the ICUs' CPs, as well as the degree to which they were interprofessional, evidence based, and renewed varied.

Conclusions

Progress has been made in relation to CPs in recent years, but there is potential for further improvements. None of the ICUs had CPs that contained all key characteristics of a high-quality, interprofessional and evidence-based CP identified in the literature. Greater knowledge sharing and cooperation within the field would be beneficial, and further research is needed.

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